| NPI | 1255448544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | R. LEON RUSSELL Pharmacy Operations COO Rdinator 206-767-1375 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WA CF00000057) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2007-11-14 |